Yuvraj Shivraj Singh Neuro-Rehabilitation Centre treats and supports head and brain-injury survivors take their first faltering steps towards a normal and productive life. Rhythma Kaul writes.

Using a specially-designed walker, 18-month-old Tanisha Rathore is learning to walk. Her faltering steps, however, are not within the confines of her home, but at the Yuvraj Shivraj Singh Neuro-Rehabilitation Centre in Jodhpur. Rathore suffered from cerebral palsy, a congenital disorder that affects the child's muscle tone, movement, and the ability to move in a coordinated way.

She is one of the 50 persons who visited the centre on Friday for their regular physiotherapy session. The rehab centre is a part of the charitable 100-bedded Rajdadisa Hospital, provides comprehensive rehabilitation comprising physiotherapy, occupational therapy and vocational training to persons with neurological disability.

More than one in four people undergoing rehabilitation suffer from head or spinal injuries they got in a road traffic accident. "We get a lot of hemiplegia (partial paralysis) and paraplegia (partial or full paralysis of the legs) caused by accidents. We have more than 60 machines to treat different parts of the body, ranging from the basic heating machine for sprains to the high-end walkers for those paralysed neck down," said Dr Pukhraj Singh Rajpurohit, in-charge of the physiotherapy unit at the centre. "Nearly 25% of the head injury cases treated here get back to a near-normal life," said Dr Rajpurohit.

Almost 80% of the head injury patients can get back to normal life if they get treated within an hour of the accident, followed by a good rehabilitation programme. "The number of vegetative survivors in severe head injury remains not more than 6%," says Dr Raj K Narayan, chairman, department of neurosurgery and director of the Harvey Cushing Institutes of Neuroscience at Long Island, New York.

"Severe head injuries, where the patient isn't able to follow simple commands even after resuscitation, accounts for 10% of the injuries, while 10% are moderate and the rest are categorised mild. Mild doesn't mean trivial, but in such cases, normal functioning can be resumed if treatment is given within a stipulated time," says Dr Narayan.

Dr Narayan is in India for a three-day event - Jodhpur One World Retreat, organised by the Maharaja Gaj Singh II of Jodhpur for his Indian Head Injury Foundation (IHIF), to focus on the alarming increase in cases of head injuries in India. "The retreat with its underlying theme 'a beautiful mind' is the propitious coming together of several interests of mine. Above all it aims to give a new critical impetus to the work of the foundation, a mission very close to my heart," said Gaj Singh II, who set up the rehab centre after his son suffered a major head injury in a polo accident in 2005. It was then that he became aware that medical facilities for head-injury patients was non-existent in India. "He recovered and is leading a normal life today, all because he got specialist care," he said.

To ensure everyone has similar access to care, Gaj Singh II founded IHIF in 2007 with a focus on prevention, diagnosis and treatment of traumatic brain injury, and to provide neuro-rehabilitation to patients suffering from severe injuries in collaboration with agencies such as Brain Trauma Foundation of USA and New York University School of Medicine.

More than one lakh people fall victim to road traffic accidents in India every year, of which nearly 50% are head injury cases. Most cannot reach treatment within one-hour of the accident, as a result of which one of every six brain victims dies. The IHIF provides trauma course to traffic police personnel, who are usually the first to reach the spot and take the victim to a hospital.

"Trauma care should be made a mandatory part of medical education. We need a professional team trained in trauma care in every hospital," said Dr Rajendra Prasad, senior neurosurgeon at New Delhi's Indraprastha Apollo Hospital, who is one of the core members of the foundation.